Oméga-3:
faits - thérapeutique et posologie
Migraines:
1,3g EPA et DHA (selon valeurs de référence DACH)
Les journaux spécialisés ont consacré
aux oméga-3 les articles suivants. La liste de ces publications
a été établie en avril 2003 et n'aspire nullement
à l'exhaustivité. Source: MEDLINE.
Ces données servent de référence pour les
médecins et les thérapeutes, de sorte à déterminer
la dose thérapeutique éventuelle dans le cadre de
migraines.
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Supplementation
with omega-3 polyunsaturated fatty acids in the management of recurrent
migraines in adolescents.
Harel Z: Divisions of Adolescent Medicine,
Providence RI, USA; Gascon G, Riggs S, Vaz R, Brown W,
Exil G
J Adolesc Health 2002 Aug 31:154-61
Abstract
PURPOSE: To examine whether dietary supplementation with
fish oil rich in very long-chain n-3 polyunsaturated fatty acids
might reduce frequency and severity of migraines in adolescents.
METHODS: Twenty-seven adolescents suffering
from frequent migraines for at least 1 year (mean 4 +/- 1 years
since migraine onset) participated in a randomized, double-blind,
cross-over study consisting of 2 months
of fish oil, 1-month washout period, and 2 months of
placebo (olive oil). Participants self-assessed severity and duration
of headache episodes (7-point faces and 10-point visual analog pain
scales, 5-point frequency and severity rating scale) throughout
the study. At the end of every 2-month treatment period, participants
rated the effectiveness of treatment on a 7-point Likert scale (1,"not
effective, not worthwhile"; 4,"moderately effective, moderately
worthwhile"; 7, "totally effective, totally worthwhile"). A score
of > or = 4 on the Likert scale was considered as improvement.
RESULTS: Twenty-three adolescents (16 girls,
7 boys, 18 Whites, 3 Hispanics, 1 African-American, 1 Cape Verdean,
mean age 15 +/- 1 years) completed the study. Compared
with frequency of headaches before the study (31 +/- 4 episodes/2
months), there was a significant (p <.0001)
reduction in headache frequency during fish oil treatment (4 +/-
1 episodes/2 months) and during placebo (olive oil) treatment (4
+/- 1 episodes/2 months) but no significant (NS) difference between
treatments. Likewise, self-assessment on a 7-point faces pain scale
revealed a significant reduction in headache severity during fish
oil treatment (2.9 +/- 0.5, p =.01) and during placebo (olive oil)
treatment (3.5 +/- 0.4, <p =.03), compared with headache severity
before study (5.0 +/- 0.3) and no significant difference between
treatments. Patients' ratings of treatments revealed that 87% experienced
reduction in headache frequency, 74% experienced reduction in headache
duration, and 83% experienced reduction in headache severity during
treatment with fish oil, compared with 78% who experienced reduction
in headache frequency, 70% who experienced reduction in headache
duration, and 65% who experienced reduction in headache severity
during treatment with placebo (olive oil, NS). About
91% stated that they would recommend fish oil to friends or relatives
with headaches vs. 91% who would recommend placebo (olive oil, NS).
CONCLUSIONS: Patients experienced a similar reduction in frequency,
duration, and severity of headaches during treatment with fish oil
and during treatment with olive oil. Although there was no significant
difference between treatments, the marked improvement from baseline
experienced by the patients suggests that the effect should not
be dismissed as simply a placebo effect. In fact, results of this
preliminary study suggest that both fish oil and olive oil may be
beneficial in the treatment of recurrent migraines in adolescents.
Further studies are warranted to compare each of these treatments
with other interventions. |
The
effect of diets containing fish and fish oils on disease risk factors
in humans.
Gibson RA: Department of Pediatrics,
Flinders Medical Center, Bedford Park, SA
Aust N Z J Med 1988 Aug 18:713-22
Abstract
Fish and fish oils are rich in omega 3 polyunsaturated fatty
acids which are capable of acting as both a source of active eicosanoids
and as inhibitors of synthesis of eicosanoids from arachidonic acid
by a variety of human cells. There is an extensive literature on
the role of omega 3 polyunsaturates in ameliorating the risk factors
associated with coronary heart disease, including both atherosclerotic
and thrombotic factors. In addition, there is a limited number of
studies which report the results of trials testing the effects of
fish oils on other clinical conditions including diabetes, arthritis,
migraine and psoriasis. There appears to be sufficient evidence
to suggest that patients at risk from heart disease could benefit
from low dose (1-6 g/day) of fish oil in conjunction with a prudent
diet. |
Omega-3
Fatty acids in inflammation and autoimmune diseases.
Simopoulos AP: The Center for Genetics,
Nutrition and Health, Washington, D.C. USA
J Am Coll Nutr 2002 Dec 21:495-505
Abstract
Among the fatty acids, it is the omega-3 polyunsaturated
fatty acids (PUFA) which possess the most potent immunomodulatory
activities, and among the omega-3 PUFA, those from fish oil-eicosapentaenoic
acid (EPA) and docosahexaenoic acid (DHA)-are more biologically
potent than alpha-linolenic acid (ALA). Some of the effects of omega-3
PUFA are brought about by modulation of the amount and types of
eicosanoids made, and other effects are elicited by eicosanoid-independent
mechanisms, including actions upon intracellular signaling pathways,
transcription factor activity and gene expression. Animal experiments
and clinical intervention studies indicate that omega-3 fatty acids
have anti-inflammatory properties and, therefore, might be useful
in the management of inflammatory and autoimmune diseases. Coronary
heart disease, major depression, aging and cancer are characterized
by an increased level of interleukin 1 (IL-1), a proinflammatory
cytokine. Similarly, arthritis, Crohn's disease, ulcerative colitis
and lupus erythematosis are autoimmune diseases characterized by
a high level of IL-1 and the proinflammatory leukotriene LTB(4)
produced by omega-6 fatty acids. There have been a number of clinical
trials assessing the benefits of dietary supplementation with fish
oils in several inflammatory and autoimmune diseases in humans,
including rheumatoid arthritis, Crohn's disease, ulcerative colitis,
psoriasis, lupus erythematosus, multiple sclerosis and migraine
headaches. Many of the placebo-controlled trials of fish oil in
chronic inflammatory diseases reveal significant benefit, including
decreased disease activity and a lowered use of anti-inflammatory
drugs. |
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